MEDICARE: DR. JAMES MADISON WALDEN JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	36414	MO

General Provider Information

NPI Number	:	1164490355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES MADISON WALDEN JR. M.D.

Provider Business Mailing Address
First Line	:	1501 BELLEVIEW AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64108-1238
Country	:	US
Telephone Number	:	816-803-8600
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 NW BRIARCLIFF PKWY
Second Line	:	SUITE 150
City	:	KANSAS CITY
State	:	MO
Zip	:	64150-7104
Country	:	US
Telephone Number	:	816-527-0031
Fax Number	:	816-527-0096

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	03/04/2018

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